| ABSTRACT Objective:To systematic evaluate the necessity of vancomycin therapeutic drug monitoring in vital organ dysfunction patients. Methods:Electronic databases such as PubMed, Embase, the Cochrane library and Chinese database (CNKI, WanFang, CBM) were searched from establishment dates of databases to January 2014. The clinical observational studies which include vital organ (renal, liver, heart) dysfunction patients using vancomycin intravenously was identified. The studies were screened according to the inclusion and exclusion criteria, the data were extracted, the quality of the included studies was assessed，and a descriptive analysis was conducted. Results:Seven observational studies were identified, including six cohort and one case control study. ①Renal dysfunction: Compare with no renal dysfunction patients, there was no statistical difference in treatment failure （P＞0.05）; the tendency of vancomycin induced nephrotoxicity was increased, and one study showed statistical difference （P＜0.05）. ②Liver disease: Compare with non liver disease patients, the tendency of vancomycin induced nephrotoxicity was increased, and one study showed statistical difference （P＜0.05）. ③Heart failure: Compare with non heart failure patients, there was no statistical difference in nephrotoxicity （P＞0.05）. Conclusion:Renal dysfunction patients and liver disease patients need vancomycin TDM more because of the increase tendency of nephrotoxicity. However, due to the low methodological quality of the included studies, more high quality and large scale studies needed to be conducted to verify this conclusion. |
